HomeMy WebLinkAboutExcavationPermitCity of Cape Canaveral
STREET EXCAVATION PERMIT
Date: t2 11 /it
t
, CCiC-
Permission is hereby granted to: Qgcou Occupational License # t�1 29RQ
Address: 11.ZG F,FE coua- 1 T�Svve 3214(0
Person in charge:
To install by: Jack and Bore Excavate by open cut: Q( X Mini Ram Method:
Uck- t ->s at: 26&ck - T"Z"'N �I pErl` w
(Name of Street) (Location)
Using: to k for: '�Ik
(Size of Casing) (Size of Pipe or Conduit)
This work will commence: 1,7- I S' L% and be completed by: l21ty /tt
t
Working hours shall be limited to (insert limitations, if any): A
The following conditions are to be maintained during and after operations:
Proper safety precautions taken (flashers, flagmen, barricades, etc.)
Rubbish and excess earth removed.
If well pointing is necessary, discharge line shall empty into storm drain manhole if
possible. Street flooding kept to a minimum.
Sod replaced by displaced material or new material of like type.
All work to be done
�per�dfr�afwings n re rse side of this permit/.
Signed: By: //%�� V /� !!/Civ✓��
(Coozrany Na (Signature)
Approved:—A. Approved: �Gs f Z t I,
blidworks Director) (City Manager)
Approved: �T
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G:/BIdg.Dept.Forms/Strect Excavation Pennit